There is general public sentiment that several adults involved in the Penn State scandal should have reported what they saw or suspected. In response to the scandal, members of Congress held a hearing on December 13 to debate revisions to mandated reporting laws including discussion of making everyone a mandated reporter. However, this will not necessarily improve reporting activities. There are several questions about how to go about revising the mandated reporting requirements in effective ways that will improve the system, not just increase the number of people reporting and reports made. As mentioned on our last post, numerous barriers exist for reporters such as the fear of repercussions like day care centers losing business due to false reports, direct service workers losing their treatment alliance, pediatricians’ concerns about not having follow up with what happens after they report, and many others. In research over the past several decades, themes of these barriers have been identified as well as solutions that could help policy makers think through what policy improvements would mean, and throughout this blog we will discuss these themes in more depth.

Barriers across Systems

Vague Legal Definitions and Requirements

Definitions: Currently, definitions of abuse and who must report is based on state law. There is rising support for a consistent legal definition of abuse and standard for reporting. Universal definitions and reporting is thought to help mitigate issues with cases that cross state lines as well as provide equity and equality in who gets reported and who gets help. It also would help professionals know what is required of them in our highly mobilized society.

Requirements: Statutes vary on what type of evidence is required and what degree of suspicion must be present, leaving it up to the individual reporter to decide what he will and will not report. More specific legal definitions and requirements will provide better guidance to reporters in the situations.

Populations: The debate is between inclusive and broad legislation versus narrow and specific legislation. Many experts are aligning themselves on the narrow side because it is more feasible to train specific groups, they do not want to flood the system with false reports, and the pool of mandated reporters can always grow. They feel that a few well-trained and involved professionals are better equipped to correctly identify and deal with suspicious situations.

Lack of Training and Awareness

Content: One of the biggest barriers for professionals is concrete knowledge of what is required of them such as signs they should be looking for, what they need to report, and where to report. The legal definitions used are purposefully vague to allow reporters both the freedom and protection to report suspicions. However, this ambiguity more often confuses professionals and leaves them to interpret what abuse is and what constitutes “sufficient evidence” on their own. This has lead to inconsistencies in who and what gets reported and when. Experts hold that the best training should include specific information on what abuse is, the signs and symptoms to look for, as well as clear guidelines about what and where to report.

Dosage: The other issue with training is the duration and frequency of it. Research suggests that the best training is interactive with low dosage and high frequency. This provides the clinicians with a supportive environment as they continue to learn and hone their skills.

Resources: The trainings described above require proper funding and time to allow the professionals to adjust to the training. Better trained professionals can improve the accuracy of reports, lessening the burden on CPS and improve the services they are able to provide.

Cross-System Collaboration and Transparency

Problems with data sharing: Each of the systems has their own individual data and privacy laws such as Health Insurance Portability and Accountability Act (HIPPA) and Child Abuse Protection and Family Educational Rights and Privacy Act (FERPA.) This makes it difficult to both identify at-risk families as well as track progress. Also, individual data does not necessarily speak to or track issues of reporting and child abuse/neglect. Through information sharing, researchers and practitioners would be better able to have a sense of the true level of abuse/neglect as well as gaps in services.

Problems with trust/transparency of CPS: Many professions cited they were dissatisfied with prior experiences with reporting and how CPS handled it. Some studies even found professionals who said it was a factor in why they did not report a suspicion. Other studies have found that professionals may simply not report because they feel they are best able to handle a situation since they have an established relationship with the child and the family already. CPS, on the other hand, is struggling to keep up with the reports, investigations, and follow up services for their families. One solution that would help both systems could be to increase other systems’ involvement with the investigation process. This would both utilize the relationships already established with the child and their families as well as provide more context and history to the investigation. It would also help relieve some of CPS burden and increase the feedback loop for professionals on reports they have made.

Barriers within Systems:

As noted above, there are several barriers that cross all the systems, but there are also barriers within each individual system. Each system has its own unique viewpoint and lens of situations but also its own barriers. For example, teachers can report a child they see every day, but they may not report because they feel they can help the child and if they report, the child may be placed out of their district. However, emergency room doctors are there at the point of crisis and are able to help ensure the immediate safety of the child, but have little knowledge of the patient’s history or influence on their future.

Early Education/School Systems

Teachers and school staff have a unique role to play in detecting potential situations of abuse and neglect. Since children are present consistently at school – or inconsistently, which could be a red flag – school personnel are able to see behavioral changes or trends in children. This sense of longevity helps provide a strong evidence base for potential abuse/neglect cases. However, barriers include large class sizes, heavy testing requirements, and lack of training in both reporting methods and signs/symptoms of abuse/neglect.

Social Workers/Psychologists

Direct practice professionals often have the most firsthand testimony of instances of abuse/neglect. This is because clients are encouraged to open up and talk about issues they are experiencing in their lives. However, this client-clinician bond can only happen when trust is established, and. to report on that abuse could break professional-client privilege and potentially halt the healing process. Another concern many clinicians express is that it will make the situation worse and/or further traumatize the person if the situation is not dealt with appropriately.

Pediatricians/Nurses/Health Professionals

The medical profession has the trust of families and exposure to physical symptoms of abuse, often at the point of crisis. This enables them to both identify patterns as well as secure the immediate safety of children. However, it also leaves them in a hard spot because it is difficult to distinguish the cause of injuries, especially in crisis settings such as the ER. When only seeing the child at the point of crisis and without an accurate and complete medical history, a doctor may miss signs and patterns of abuse and neglect. Also, they often have very strict interpretation of evidence and are reluctant to report anything that cannot be firmly proven.

To Wrap Up…

As mandatory reporting statues are reviewed, policymakers need to keep in mind all of these barriers in the context of the larger picture. One way to do this is to use research to guide decision-making. As highlighted in expert testimony from Frank Cervone, Executive Director of the Support Center for Child Advocates in Philadelphia, at the congressional hearing, there are valuable lessons to be learned from the many innovative approaches states have taken in dealing with mandatory reporting. He went on to advocate for careful study of the research on best models of policy, system collaboration, and treatment interventions. This way the laws enacted will be thoughtful responses that will both improve the system and better meet the needs of children and their families instead of being a reactionary policy.